RE@L’s “1Up On Vaping™” LearningProduct brings to our RE@LBlog Readers a series of interview blogs from two local doctors on the perils of teen vaping and nicotine use: Dr. Anne Griffiths and Dr. Rose Marie Leslie.

All six RE@LBlog interviews were conducted by RE@L Media Content Producer, Tacy Mangan. Each will be shared with our readers in coming weeks. 

Dr. Anne Griffiths is a pediatric pulmonologist at Children’s Minnesota and Children’s Respiratory and Critical Care Specialists. Her work with teenagers includes treating those with vaping associated lung injury.

Click on the photo for more information on Dr. Griffiths. Dr. Anne Griffiths presents the first of her three blog interviews below.

BLOG PRESENTATION 1 of 3: “THE STATUS OF TEEN VAPING FROM A DOCTOR ON THE FRONT LINES OF TREATMENT – THE BURDEN OF VAPING”:

“(Vaping) causes a behavioral piece and use becomes habitual, since they’re constantly vaping throughout the day in a way that seems to really be a higher burden of use compared to traditional cigarette use.” – Dr. Griffiths

“What’s the Current Status of Teen Vaping?”

Tacy Mangan (TM): “Based on your practice, Dr Griffiths, what would you say is the status of teen vaping today?

Anne Griffiths (AG): We’re still seeing that vaping is extremely popular among teenagers. In the last year, we’ve seen a bit of a shift from preference of devices and we’re seeing some preference where teens are choosing more disposable devices this year.

TM: Why do you think teens are attracted to vaping?

AG: I think teens are attracted to vaping for a couple of reasons. One is that it’s really been marketed as something fairly safe. There’s been a lot of industry emphasis on purity or the sense that there are fewer ingredients and therefore, it’s safer. There’s a lot of marketing around the purity, quote unquote, of the product and I think that appeals to teens, the sense that there are fewer ingredients and what they’re inhaling is safer compared to traditional combustible products. That’s been a marketing approach for lack of a better term, that has appeal to teens.

There’s also a big market for flavorings in vaping products that we tend to not see at this point in combustible products. There are numerous products that have either birthday cake flavors or fruit flavors or cereal flavors, flavorings that appeal to teenagers. And then there are also the products that claim to, some accurately, perhaps some not accurately, that they don’t have nicotine in them, but just have flavorings.

Oftentimes that’s been one of the first things that a teenager might try, something that purports to be only flavoring based, whether or not that’s accurate. Not only are those substances often marketed as being fairly safe, but there’s the sense that they will help manage anxiety or mental health symptoms or difficulty sleeping. As a result, I think, there’s been an uptick in utilizing vaping products as a way to sort of inappropriately self-medicate.

TM: So, where is that information coming from? Where are teens getting that kind of information?

AG: When we talk about vaping in general, we’re talking about different kinds of things that people vape. There are the sort of flavor based products and nicotine based products. There are THC based products and a lot of the chatrooms on the Internet or large websites or social media talk a lot about THC based products, which is the active component within marijuana.

They state those products may help with easing anxiety or help someone sleep and I think there is a difference between being medicated through sleep versus actually experiencing healthy sleep. So, there’s that misinformation.

There has been a lot of information from those unofficial channels over the Internet that seem to encourage utilization of off label and illegal use of THC based products for sleep. That’s also where I see those products used to deal with anxiety. Sleep is usually promoted through the use of THC based products, not so much nicotine. Nicotine ends up being more of a stimulant, but we see that there’s a lot of overlap of teens who start with nicotine and then progress to THC based vaping.

“So, Why Is Teen Vaping So Detrimental And On The Rise?”

TM: Why is vaping so detrimental for adolescents?

AG:I think it’s been a real game changer in terms of ease of utilization, starting with nicotine, salt-based products. The product was designed to be more comfortable and was designed to not hurt when you inhaled it at the level of your throat. So, teens don’t feel the same level of discomfort when they vape compared to when they smoke a cigarette and that makes them feel that vaping must be safer, since it’s not painful.

Add to that, vaping is something to easily start and stop numerous times a day, a hundred times a day. You can do it at home, you can do it in the car. You go to school without people noticing you’re vaping. That’s a problem.

It has a behavioral piece and e-cigarette device use becomes habitual. Teens can vape frequently throughout the day with almost no interruption or inconvenience in a way that seems to allow for a higher burden of use compared to traditional cigarette use.

Now with vaping associated lung injury we see that heavy vaping may cause kids to have difficulty walking up a set of stairs. They may feel short of breath, trying to open the cabinet and get cereal out. Anecdotally, I’ve seen patients who present to lung clinic with new intolerance of their sport activity or exercise who are vaping. So, it’s not that it’s harmless, but that initial feeling of “this doesn’t burn my throat as much as cigarettes”, and the fact that it’s a lot easier to stop and start throughout the day, has been a recipe for really impressive behavioral habit forming and addiction forming early on.

“What Is The Key Vaping Concern Today? Covid!!!”

TM: What are you seeing with the connection between youth vaping and Covid19?

AG: I have a lot of concerns about vaping and what we know about how the flavorings in vaping products impair and dysregulate the immune system. There’s also emerging data regarding vaping and a common pathway in the body that we think Covid-19 accesses to enter the lung, called ACE2. I think anything that really is interfering with our immune system at this point is a problem, also in THC based vaping. We know that there’s been a lot of marketing in the cannabis industry around anti-inflammatory purported benefits and decreasing your inflammation in general. I wouldn’t say that’s always a good thing.

I also worry that when we see these young adults and teenagers in the ICU, oftentimes we learned from last year’s vaping epidemic with illegal THC based products and vitamin E acetate, that teens would report denying vaping to the E.R. doc or to the first person who admitted them to the hospital, and that by Dr. No.7 or nurse number seven, that’s when they were willing to disclose that they were vaping. When asked frequently enough, they realize it might be very important to disclose and impacting their health.

So, I’m concerned as I see some of our young ICU patients with Covid, I worry that there’s a major underreporting of vaping habits.

TM: Are you seeing the adolescent Covid numbers go up?

AG: We know that nationally we’re seeing an increase in all pediatric cases, in all age groups. So, yes, Covid has been on the rise.”

====== To Be Continued =====

STAY TUNED FOR OUR NEXT RE@L VAPING INTERVIEW WITH DR. ANNE GRIFFITHS: 

“HOW VAPING CAN CHANGE THE WAY WE THINK AND FEEL.”

 CLICK HERE FOR ANOTHER INFORMATIVE  LINK FROM “CHILDREN’S MINNESOTA.”

In what ways can vaping affect a teen’s mental health? 

Which treatments for addiction really work?

Get the answers to these key questions in our biweekly RE@LBlog Interview # 2.